A dive incident’s psychological aftermath

THE DIVER

The diver was a 48-year-old male with four years of diving experience and 10 dives in the previous month. His medical history included hypertension and gastroesophageal reflux disease (GERD), which were controlled by medications. He used a prescription sleeping pill as needed.

THE INCIDENT

The diver was on a trip to a popular Hawaiian island. About 10 minutes into his first dive he had a regulator failure in which his mouthpiece came apart from his second stage. He thought the second stage was still in his mouth – though only the mouthpiece remained – so when he realised he couldn’t breathe he assumed the first stage had malfunctioned. He had just finished exhaling and was ready to take another breath. He began to panic because he did not think anyone was close enough to share air with him, and he found himself fighting the temptation to inhale water. He was without air for about 25 seconds before he remembered he had a spare air cylinder. He took two or three breaths from it before he was able to reach his buddy’s spare second stage.

The diver had just had his regulator serviced, and this was his first dive with it since then. He was fortunate to have purchased the spare air a year earlier; things could have been much worse. He was an emergency-room physician and knew the consequences of being unprepared.

THE COMPLICATIONS

The diver was “shell-shocked after the event and since the event” as he dealt with the aftereffects. He had trouble sleeping due to nightmares and had flashbacks of running out of air.

DISCUSSION

The diver experienced a fairly minor equipment failure in the unexpected separation of his mouthpiece from his second stage. The regulator had a proprietary mouthpiece clamp with a cam latch, and upon reflection he supposed the clamp was not replaced after the